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目的 探讨下入路介入法治疗输尿管狭窄的应用效果。材料与方法 2 5例经影像学确诊为输尿管狭窄并上尿路积水中 ,2 0例为输尿管取石术后狭窄 ,5例为不明原因非外压性狭窄。经膀胱镜将导丝送至输尿管狭窄以上 ,采用导丝导管交换及对比剂定位技术 ,在狭窄处行球囊扩张。结果 18例成功放置双J管行内引流 ,1例因输尿管上段高度纡曲狭窄置管失败 ,6例行单纯球囊扩张。术后分别观察 3、6、12个月及 1～ 5个月 ,复查B超、IVP显示肾积水程度减轻 ,肾功能改善。单纯球囊扩张者再狭窄程度在 40 %以下。双J管位置准确 ,无移位 ,16例顺利取出。结论 下入路介入法具有创伤小、操作简单、定位准确、并发症少 ,扩张和引流效果好等优点 ,是治疗输尿管狭窄的一种安全、有效的方法
Objective To investigate the effect of interventional approach in the treatment of ureteral stricture. Materials and Methods Twenty-five patients with ureteral stricture and upper urinary tract hydrothorax were diagnosed by imaging. Twenty patients were stenosed by ureterolithotomy, and five patients were non-occlusive stenosis of unknown cause. The cystoscope guide wire will be sent to the ureter above the stenosis, the use of guide wire catheter exchange and contrast agent positioning technique, the balloon at the stenosis Department expansion. Results 18 cases were successfully placed double J tube drainage, 1 case of high ureteral stricture stenosis catheter failure, 6 cases of simple balloon dilatation. Postoperative observation 3,6,12 months and 1 to 5 months, review B ultrasound, IVP showed reduced hydronephrosis, renal function improved. Simple balloon dilator restenosis is below 40%. Double J tube position accurate, no shift, 16 cases removed smoothly. Conclusion The interventional approach has the advantages of less trauma, simple operation, accurate positioning, less complications, good dilatation and drainage, and is a safe and effective method for the treatment of ureteral stricture